NPIMap

Organization Active NPI

J. Michael Su D.D.S., P.a.

  • Dentist
  • Sugar Land, TX
National Provider Identifier
1801002282
Registry record updated Jul 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
19092 Issued in TX
Legal business name
J. MICHAEL SU D.D.S., P.A.
Practice address
6655 Greatwood Pkwy
Sugar Land, TX 77479-6314
Phone
(281) 341-5116
Fax
(581) 341-5126
NPI assigned
May 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. John Michael Su, DDS
Title
President
Phone
(281) 341-5116

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 19092 TX Primary

Addresses

Primary practice location

6655 Greatwood Pkwy
Sugar Land, TX 77479-6314

Mailing address

6655 Greatwood Pkwy
Sugar Land, TX 77479-6314
Phone (281) 341-5116

Other identifiers 2

IdentifierTypeStateIssuer
090763601MedicaidTX
009882401MedicaidTX

National Provider Directory

National Provider Directory

Locations

6655 Greatwood Pkwy
Sugar Land, TX 77479
Phone (281) 341-5116

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375056000000",
    "number": "1801002282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6655 GREATWOOD PKWY",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774796314",
            "telephone_number": "281-341-5116",
            "fax_number": "581-341-5126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6655 GREATWOOD PKWY",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774796314",
            "telephone_number": "281-341-5116",
            "fax_number": "581-341-5126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. MICHAEL SU D.D.S., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2013-07-29",
        "status": "A",
        "authorized_official_last_name": "SU",
        "authorized_official_first_name": "JOHN MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "281-341-5116",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "19092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "090763601",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009882401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.